Clinical Leadership in Nursing and Healthcare PDF
Preview Clinical Leadership in Nursing and Healthcare
Clinical Leadership in Nursing and Healthcare Clinical Leadership in Nursing and Healthcare Values into Action Edited by David Stanley Second Edition This edition first published 2017 © 2017 by John Wiley & Sons, Ltd The first edition was published by Macmillan Education Australia in 2011 Registered Office John Wiley & Sons, Ltd, The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK Editorial Offices 9600 Garsington Road, Oxford, OX4 2DQ, UK The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK 111 River Street, Hoboken, NJ 07030‐5774, USA For details of our global editorial offices, for customer services and for information about how to apply for permission to reuse the copyright material in this book please see our website at www.wiley.com/wiley‐blackwell The right of the author to be identified as the author of this work has been asserted in accordance with the UK Copyright, Designs and Patents Act 1988. All rights reserved. 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Set in 10/12pt Warnock by SPi Global, Pondicherry, India 1 2017 To my mum, Marj Stanley (1926–) vii Contents Notes on Contributors xix Foreword xxiii Preface xxv Acknowledgements xxvii Part I Clinical Leaders: Role Models for Values into Action 1 1 Clinical Leadership Explored 5 David Stanley Introduction 5 Clinical Leadership: What Do We Know? 5 Attributes Less Likely to be Seen in Clinical Leaders 7 Not Controlling 7 Not Visionary 8 Not Shapers 9 Attributes More Likely to be Seen in Clinical Leaders 10 Clinical Competence/Clinical Knowledge 11 Approachability 11 Empowered/Motivator or Motivated 11 Supportiveness 12 Inspires Confidence 12 Integrity/Honesty 12 Role Model 12 Effective Communicator 12 Visible in Practice 13 Copes Well with Change 14 Other Attributes 14 Values: The Glue that Binds 14 Who are the Clinical Leaders? 15 Clinical Leadership Defined 17 Why Clinical Leadership Now? 18 A New Agenda 18 Changing Care Contexts 18 Change Equates to more Leadership 18 More Emphasis on Quality 19 viii Contents Summary 20 Mind Press‐ups 21 References 21 2 Leadership theories and styles 25 David Stanley Introduction: Leadership – What Does It All Mean? 25 Leadership Defined: The Blind Man’s Elephant 27 No One Way 29 Leadership Theories and Styles 29 The Great Man Theory: Born to Lead? 29 The Big Bang Theory: From Great Events, Great People Come 30 Trait Theory: The Man, not the Game 30 Style Theory: It’s How You Play the Game 32 Situational or Contingency Theory: It’s about Relationships 34 Transformational Theory: Making Change Happen 35 Transactional Theory: Running a Tight Ship 37 Authentic/Breakthrough Leadership: True to Your Values 37 Servant Leadership: A Follower at the Front 38 The Right Leader at the Right Time 39 Summary 41 Mind Press‐ups 42 References 42 3 Followership 47 David Stanley Introduction: From Behind They Lead 47 Defining Followership 47 Followers’ Responsibilities 48 The Good Follower 52 The Not‐So‐Good Follower 53 Summary 56 Mind Press‐ups 56 References 57 4 Congruent Leadership 59 David Stanley Introduction: A New Theory 59 Congruent Leadership: A Beginning 60 It all Started with Clinical Leadership 60 Congruent Leadership Theory Explored 69 A Solid Foundation 71 The Strengths of Congruent Leadership 74 Grassroots Leaders 74 Foundation for Other Theories 75 Strong Link between Values and Actions 75 Supports Further Understanding of Clinical Leadership 76 Anyone can be a Congruent Leader 77 Contents ix The Limitations of Congruent Leadership 77 New Theory 77 Similar to Authentic Leadership and Breakthrough Leadership 77 Not Driven by a Focus on Change 77 Not Suitable for Leaders with ‘Control’ as an Objective 78 Congruent Leadership, Change and Innovation 78 Congruent Leadership and Power 79 Congruent Leadership and Quality 81 Summary 85 Mind Press‐ups 86 References 86 5 Leadership and Management 91 David Stanley Introduction: Necessary and Essential 91 Misunderstood 92 A House Divided Cannot Stand 93 Leadership and Management: Apples and Pears? 95 Leadership and Management: Snakes and Ladders? 96 Leadership and Management: Heart and Head? 98 A Culture Shift 100 Summary 102 Mind Press‐ups 102 References 103 Part II Clinical Leadership tools: How to Influence Quality, Innovation and Change 107 6 Organisational Culture, Clinical Leadership and Congruent Leadership 109 David Stanley and Sally Carvalho Introduction: Values First 109 What is Organisational Culture? 109 A Culture of Care and Compassion 111 Culture and Leadership 113 How Congruent Leaders Shape Culture 114 Clinical Leadership, Education and Training 118 Summary 120 Mind Press‐ups 121 References 121 7 Managing Change 125 David Stanley Introduction: Tools for Change 125 All Change 126 Approaches to Change 128 SWOT Analysis 128 Stakeholder Analysis 129 Pettigrew’s Model 130 x Contents The Change Management Iceberg 131 PEST or STEP 132 Kotter’s Eight‐stage Change Process 132 Nominal Group Technique 133 Process Re‐Engineering 134 Force‐Field Analysis 134 Restraining Forces 135 Driving or Facilitating Forces 135 How Do You Find Either Restraining or Facilitating Forces? 135 Other Approaches 137 Initiating, Envisioning, Playing, Sustaining: A Theoretical Synthesis for Change 137 Seven S‐Action Words Model for Organisational Change 137 Beckhard and Harris’s Change Equation 138 People‐Mover Change Model: Effectively Transforming an Organisation 138 Instituting Organisational Change: An Examination of Environmental Influences 138 Change is Never Simple, Even with a Model 138 Resistance to Change 139 Self‐Interest and Conflicting Agendas 139 Increased Stress 139 Uncertainty 140 Diverging Points of View 140 Ownership 140 Recognising the Drivers 141 Some People Just do not Like Change 141 Recognising Denial and Allowing Time for Reflection 141 Successfully Dealing with Change 141 Summary 145 Mind Press‐ups 145 References 146 8 Clinical Decision Making 149 Veronica Swallow, Joanna Smith and Trish Smith Introduction: A Choice 149 Why do We have to make Decisions? 149 What is a Decision? 150 Accountability 150 Terms 151 Decision‐Making Approaches 151 Theories of Clinical Decision Making 155 Intuitive‐Humanistic Model 156 Systematic‐Positivist, Hypothetico‐Deductive and Technical Rational Models 157 Integrated Patient‐Centred Model 157 IDEALS Model 157 Managerial Decision‐Making Process 158 Clinical Leadership and Decisions 158 Why Decisions Go Wrong 159 Not Using the Decision‐Making Framework 159 Contents xi Flawed Data 159 Bias 159 Seeking to Avoid Conflict or Change 159 Ignorance 159 Hindsight Bias 160 Availability Heuristics 160 Over‐Confidence in Knowledge 160 Haste 160 Group Decision Making 160 Advantages of Group Decisions 161 Disadvantages of Group Decisions 161 Characteristics of Effective Decision Makers 161 Summary 163 Mind Press‐ups 164 References 164 9 Creativity 167 David Stanley Introduction: A New Way Forward 167 What is Creativity? 167 Building Creative Capacity 170 Techniques for Developing Creativity 170 Relax 170 Keep a Notebook or Journal 171 Journaling 171 Record Your Ideas 171 Do or Learn Something New Each Day 171 Learn to Draw 171 Become a Cartoonist 171 Learn to Map Your Mind 171 Try Associational Thinking 172 Go for a Walk 172 Adopt a Genius 172 Open a Dictionary 172 Study Books About Creative Thinking 172 Flood Yourself with Information 172 Attend Courses 172 Listen to Baroque Music 172 Face a New Fear Every Day 172 Develop Your Imagination 173 Leave Things Alone for a While 173 Find a Creative Space 173 Develop Your Sense of Humour 174 Define Your Problem 174 Know Yourself Well 174 Use Guided Reflection 174 Be Mindful 174 xii Contents Focus 174 Do not be Afraid to Fail 174 Develop Some Techniques for Creative Thinking 174 Barriers to Creativity 175 Organisational Barriers 175 Competition 175 Organisational Structure 176 Being Too Busy to Address a Problem 176 Too Hectic an Environment 176 A Sterile Environment 176 Poor or Harsh Feedback 176 Rules 176 Unrealistic Production Demands 177 The Boss is Always Right 177 Poor Communication 177 Personal Barriers 177 Fear of Criticism 177 Our Belief that we are Not Creative 177 Fear of Change 177 Ego 177 Beliefs 178 Lack of Confidence 178 Stress 178 Previous Negative Experiences with Risk 178 Negative Self‐Talk 178 Routines 178 Other Barriers 178 Daily Distractions 178 Not Having a Place to go or Time to Get There 179 Drugs 179 Leadership and Creativity 179 Summary 182 Mind Press‐ups 182 References 182 10 team Working 185 David Stanley Introduction: Effective Teams 185 Healthcare Teams 186 Do We Really Need Teams? 187 Teams and Groups 188 Established Teams 189 High‐Performance Teams 189 Ok or Functional Teams 190 Struggling Teams 190 Creating Powerful Teams 191 Support and Challenge 192 Team Building 193
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